Human papillomavirus infection (human papillomavirus or HPV) is a common disease in women; men are less susceptible to it. The papilloma virus is transmitted from a human carrier during sexual intercourse, through contact with skin, and also from mother to child during childbirth. When HPV is infected or activated, warts, genital warts (genital warts) appear on the human body, and in women gynecological diseases. Some papilloma viruses are oncogenic. Treatment of human papillomavirus infection in women and men must be carried out with modern effective drugs.
Antiviral
Antiviral drugs for HPV have an antibacterial effect, preventing tumors from growing and spreading further.
Allokin-Alpha
Active ingredient – alloferon-oligopeptide
Treatment of HPV with this antiviral drug is carried out according to clinical indications.
For HPV, the dosage is calculated as 1 milligram of the drug every 2 days. During treatment, 6 injections should be given.
Side effects: weakness, dizziness, formation of new rash elements.
Contraindications: severe autoimmune diseases, pregnancy, lactation period, childhood, hypersensitivity to the components of the drug.
Acyclovir
The active ingredient is acyclovir. Available in the form of tablets, ointments and powder.
A medicine that suppresses the virus by integrating into its DNA and prevents it from reproducing. The best and most reliable drug for HPV.
Side effects: skin rashes that disappear after discontinuation of the drug, nausea, diarrhea and abdominal pain.
Contraindicated in case of hypersensitivity to acyclovir.
Interferon (Lokferon, Inferon, Interferon leukocyte human dry lyophilisate)
The active substance is interferon alpha. Available in powder form in ampoules and suppositories.
An antiviral drug for HPV is used for genital warts.
Dosage, frequency and duration of use are determined based on clinical indications.
The use of interferon alpha drugs during pregnancy is possible only in cases where the expected benefit to the mother outweighs the potential risk to the fetus. It is recommended to stop breastfeeding while taking the drug.
Side effects: fever, headache, loss of appetite, nausea, vomiting, diarrhea, hypotension, arrhythmia, drowsiness, impaired consciousness, ataxia, dry skin, erythema, skin rash.
Contraindications: for severe heart disease, thyroid gland, impaired liver and kidney function, epilepsy, hypersensitivity to interferon alpha.
Ribavirin (Ribavirin-Bio, Ribapeg, Ribamidil, Ribavirin-FPO)
The active ingredient is ribavirin. Available in the form of tablets and capsules.
It is used as an antiviral agent to treat virus-affected skin and mucous membranes.
The dosage is prescribed individually depending on the clinical indications.
Side effects: headache, dizziness, general weakness, malaise, insomnia, asthenia, depression, irritability, decreased or increased blood pressure, brady- or tachycardia, palpitations, cardiac arrest, hemolytic anemia, leukopenia, dyspnea, cough, pharyngitis, shortness of breath, bronchitis, dry mouth, loss of appetite, nausea, vomiting, diarrhea, abdominal pain, constipation, perversion of taste.
Contraindications: chronic heart failure, myocardial infarction, renal failure, anemia, liver failure, decompensated cirrhosis of the liver, autoimmune diseases, untreatable thyroid diseases, severe depression with suicidal tendencies, childhood and adolescence under 18 years of age, pregnancy, lactation, hypersensitivity to ribavirin.
Immunomodulatory
Immunomodulators are a group of drugs that activate the immune system. Under the influence of immunomodulatory drugs, the production of leukocytes is activated and the body’s natural fight against the virus is enhanced.
Viferon (Laferobion)
The active ingredient is interferon alpha-2b. Available in the form of suppositories, ointments and gels.
An immunostimulating drug against HPV is used in combination general therapy for adults, 1 suppository 2 times a day every 12 hours every day for 5-10 days. The course of treatment can be continued according to clinical indications.
During pregnancy, the drug is approved for use from 14 weeks. During lactation there are no restrictions.
Side effects: allergic reactions in the form of skin rash and itching, which disappear within 72 hours after discontinuation of the drug.
Contraindications: individual intolerance.
Genferon
Active ingredients: interferon alpha-2b, taurine, benzocaine.
The modern drug is indicated for HPV treatment, with its help the effectiveness of the fight against viruses increases.
Contraindications: individual intolerance to the components of the drug, 1st trimester of pregnancy.
Immunomax
The active substance is acidic peptidoglycan. Release form: lyophilisate for preparing a solution for intramuscular administration.
An immune drug for HPV that enhances defense mechanisms against infections caused by viruses. Indicated for the correction of weakened immunity and treatment pathological conditions(condylomas, warts, dysplasia and others) caused by the human papillomavirus.
Contraindications: prohibited for use in children under 12 years of age and in patients with hypersensitivity to the drug. Should not be used during pregnancy unless the benefit to the woman outweighs the possible risk to the fetus. Not recommended for nursing mothers.
Lycopid
The active substance is glucosaminylmuramyl dipeptide. Available in tablet form.
An anti-HPV drug used for diseases accompanied by secondary immunodeficiency.
The course of treatment is carried out for 10 days, the daily dose is 10 milligrams once a day 30 minutes before meals.
From side effects an increase in body temperature to 37.9°C was detected; this phenomenon is short-term and occurs at the beginning of treatment.
Contraindications: individual intolerance, pregnancy, breastfeeding, exacerbation of autoimmune thyroiditis, diseases that are accompanied by high fever or elevated temperature bodies.
Also pay attention to the list of other hidden infections in women that can cause significant harm to health
Combined
Action combination drugs is aimed at destroying the cell with the HPV genome and restoring the function of lymphocytes during immunosuppression, which accelerates the elimination of papillomavirus due to the active synthesis of interferon.
Isoprinosine (Groprinosine)
The active ingredient is inosine pranobex. Available in tablet form.
A drug for human papillomavirus infection (HPV) in men and women, including in the genital area.
The dosage of the drug for adults is prescribed 2 tablets 3 times a day, for children - 1/2 tablet per 5 kilograms of body weight per day in 3-4 doses for 14-28 days as monotherapy.
The safety of using Isoprinosine during pregnancy and lactation has not been established, therefore the use of the drug is not recommended.
Side effects: nausea, vomiting, epigastric pain, temporary increase in the activity of transaminases and alkaline phosphatase in the blood plasma, itching, headache, dizziness, weakness, polyuria, joint pain, exacerbation of gout, increased concentration of urea in the blood plasma.
Contraindications: urolithiasis disease, gout, arrhythmias, chronic renal failure, children under 3 years of age (body weight up to 15-20 kilograms), hypersensitivity to the components of the drug.
Panavir
The active substance is polysaccharides from the shoots of Solanum tuberosum. Available in the form of suppositories, gel and solution for intravenous administration.
Indicated for decreased immunity in combination with infectious diseases.
An anti-HPV drug administered intravenously in a slow stream of 200 micrograms. For human papillomavirus infection, administer 3 times with an interval of 48 hours for 1 week and 2 times with an interval of 72 hours for 2 weeks.
Side effects: allergic reactions are possible.
Contraindications: severe diseases of the kidneys and spleen, lactation period, childhood, hypersensitivity to the herbal remedy. Use with caution during pregnancy.
Ferrovir
The active ingredient is a complex of sodium deoxyribonucleate with iron. Available in solution form.
It is used intramuscularly as part of combination therapy for the treatment of HPV.
Dosage – 5 milliliters 1-2 times a day for 10 days.
Side effects: fever, hyperemia, moderate pain at the injection site.
Contraindications: pregnancy, lactation (breastfeeding), childhood, hypersensitivity to the drug.
Cycloferon
The active ingredient is meglumine acridone acetate. Available in the form of tablets and solution.
An antiviral drug for HPV in women and men, it has a destructive effect on papillomavirus cells and at the same time strengthens the immune system.
Children and adults need to take 4 tablets every 3 days for 23 days. After this, the dose is reduced to 4 tablets once every 5 days. General course treatment should last 3.5 months.
Side effects: allergic reactions.
Contraindications: liver cirrhosis in the stage of decompensation, children under 4 years of age, pregnancy, lactation ( breastfeeding), individual intolerance to the components of the drug.
Tablets for papillomas are among the most popular medications. This is because the human papillomavirus (HPV) is one of the most common on Earth. According to research, about 60% of people are infected with it.
The effect of papillomavirus on the human body
Science knows about 600 varieties of HPV. Some of them provoke the appearance of warts and condylomas, while others can cause malignant tumors. The virus integrates into the DNA of epithelial cells and causes their pathological growth. Infection occurs through household or sexual contact.
The main symptoms of the disease are condylomas, warts and other neoplasms that appear on the skin and mucous membranes of the hands, feet, face, neck, chest, and genitals. Growths can also occur on internal organs, for example, on the walls of the esophagus or intestines, in the renal pelvis, on the trachea, vocal cords, and ureter.
With HPV, unpleasant symptoms may be absent for a long time. The duration of the latent period sometimes reaches several years. The first signs of the disease appear in patients with weakened immune systems, namely: in people who have suffered severe infectious diseases, have undergone antibiotic treatment or surgery. The risk group includes people living in conditions of constant stress, pregnant and lactating women, HIV carriers, and people with alcohol and drug addiction.
Basic ways to fight the disease
Collateral effective fight the disease is treated correctly. Many people, having discovered tumors in themselves, rush to buy medications and start using them at home. However, self-medication can lead to serious complications, including degeneration. benign neoplasms into malignant ones. To prevent this, you need to consult a doctor.
At the appointment, a dermatovenerologist will examine the growths, perform a biopsy and submit the resulting material for histological analysis. He may refer the patient for laboratory tests, the purpose of which is to determine the specific strain. The results of the tests determine which tablets for the human papillomavirus the doctor will prescribe to the patient. The selection of medications is carried out individually for each patient, depending on the type of virus present in his body, as well as taking into account general condition his health.
Therapy against the human papillomavirus must be comprehensive, it is carried out in several directions at once. Treatment is carried out using the following means:
- antiviral drugs that reduce the intensity of the impact of HPV on the patient’s body;
- immunomodulators that increase a person’s immunity and allow him to more successfully fight the disease;
- ointments and creams used to remove growths.
In an outpatient clinic or beauty salon, hardware methods for removing tumors, for example, cryodestruction, laser removal, electrocoagulation, removal of formations surgically or using a radioknife.
Features of the use of tablets for papillomavirus
Many patients tend to treat papillomas on the body with tablets because they are the easiest to use. But it should be remembered that only antiviral and immunomodulating drugs are produced in tablet form, that is, those drugs that improve the condition of the body and prevent the appearance of new warts, but do not eliminate existing growths. To get rid of papilloma and prevent the appearance of new formations, you need to take pills and at the same time use creams and ointments.
It must be remembered that it is impossible to completely get rid of human papillomavirus infection, but the correctly selected remedy can improve immunity and suppress the replication of the virus. You can take such drugs only as prescribed by a doctor, because different strains of HPV are sensitive to different antiviral drugs, and only a doctor can determine which ones are suitable for a particular patient.
Mandatory part complex therapy is to take immunomodulators, they increase the body's defenses against recurrent infections. Their main active ingredient is purified Interferon, which is obtained from human blood cells. It is these cells that are produced in a healthy person when pathogens enter the body. Interferon has a similar effect: it prevents the proliferation of HPV, as it suppresses the production of its proteins. Some Interferon drugs have an antiviral effect, for example, Acyclovir, Viferon.
You need to take immunomodulators with caution, because they can activate those links immune system, which are already active, and at the same time have a depressing effect on those links whose activity is insufficient. And this will lead to imbalance in the body. Only a doctor can choose the right immunomodulator.
Properly administered drug therapy leads to a decrease in the activity of viruses, stabilization of the immune system, and the disappearance of itching in the area of tumors. The growths themselves may decrease in size and even disappear completely.
Isoprinosine, Groprinosine
Isoprinosine, which belongs to the group of antiviral drugs, is an excellent remedy for papillomas on the body. It is able to directly affect HPV and suppress its development by blocking the synthesis of dihydropteroate synthetase. At the same time, Isoprinosine stimulates the body’s protective functions, activates the synthesis of immunoglobulins and leukocytes, thereby promoting the complete destruction of affected cells.
The drug is available in the form of tablets, each containing 500 mg active substance– inosine pranobex. The treatment regimen is selected by the doctor individually for each patient, taking into account the type of virus, age and weight of the patient. Adults, as well as children over 12 years of age, are most often prescribed medication according to the standard regimen: 1-2 tablets 4 times a day. You need to drink them with plenty of water.
The duration of the therapeutic course varies from 2 weeks to 1 month. Then you need to take a break for 30 days and repeat the therapy 2 more times. The use of Isoprinosine is allowed for children from 3 years of age; the dosage for them is calculated depending on body weight: 500 mg of inosine pranobex per day per 10 kg of child weight. This dose should be divided into 3 doses.
This medicine enhances the effect on the body of other immunomodulatory and antiviral drugs that are used to treat papillomas. Therefore, Isoprinosine is considered an ideal drug for complex therapy. In addition, it can be prescribed after surgical removal of condylomas to prevent relapse of the disease. A possible side effect of taking the drug is organ dysfunction digestive system, in particular the liver.
An analogue of Isoprinosine is Groprinosine; its advantage is that it has a milder effect on the patient. Therefore, this medication is often prescribed to children, the elderly, and patients suffering from cardiovascular diseases.
Its main active ingredient is magniferin, extracted from a plant called pennywort. Magniferin destroys the DNA of the virus. Each tablet contains 10 mg of this substance. Alpizarin should be started on the first day of relapse of the disease.
Since the medicine is made from natural ingredients, even children can drink it. Dosage for children is 1 tablet 3 times a day, and for adults – 2 tablets 3 times a day. Taking the medication is not associated with eating food. The duration of treatment should be 3 weeks, and in case of relapse of the disease - 4 weeks. Side effects from taking the medicine include digestive disorders, fatigue, and allergies.
Rimantadine
This powerful drug, which ensures the destruction of the outer shell of the papillomavirus. Available in powder form for children, as well as tablets recommended for use by adult patients. Widely used to prevent relapse of the disease after surgical removal of growths. Also indicated for use as prophylactic after contact with an HPV carrier. In such cases, the medicine should be taken once a day for 14 days.
Rimantadine is contraindicated for use in patients with intolerance to its components, as well as with severe pathologies of the kidneys, liver, and gastrointestinal tract. Not to be taken during pregnancy and lactation. Side effects are rare and include indigestion, tachycardia, and increased nervous excitability. These symptoms disappear within a few hours after discontinuation of the drug.
Other medications
Treatment of papillomavirus can also be carried out with other medications that demonstrate high efficiency and safety of use. These include:
- Acyclovir. Available in the form of tablets, ointments, creams. It is a synthetic analogue of a purine base; it has an immunostimulating effect and also blocks the synthesis of viral DNA, thereby preventing the proliferation of pathogens. Acyclovir can be used for children from 2 years of age, the standard dosage regimen is 5 times a day. At severe forms illness, it is possible to increase the dosage to 2 pieces at a time. Contraindications for use are allergies to the components of the drug, as well as lactation. It should be taken with caution when renal failure, pregnancy.
- Cycloferon. A medication that stimulates the synthesis of interferon and increases the body's defenses. Used to treat papillomavirus, as well as other serious diseases, such as HIV. The dosage is determined by the strain of the virus present in the patient's body. Cycloferon can be addictive, so it is used only as prescribed by a doctor, for a limited amount of time.
- Galavit. Increases the body's defenses, stops the reproduction of HPV, eliminates inflammation. Drink 4 times a day. Contraindications are individual intolerance, pregnancy, age under 12 years.
- Arbidol. This drug for papillomavirus not only has a detrimental effect on the infection, but also increases local immunity. Thanks to this, the medicine reduces the risk of infection with other strains of HPV. Arbidol is recommended to be used after contact with an infected person (drink 0.2 mg once a day for 14 days). After surgery, the medicine should be taken for 3-5 days, 0.5 g 4 times a day. A possible side effect is an allergic reaction. Arbidol is not recommended to be taken simultaneously with drugs containing umifenovir, because these substances enhance the effect of each other.
- Lycopid. Has an immunostimulating effect and also helps fight papilloma viral infection, fungi, pathogenic microorganisms. Likopid enhances the therapeutic effect of other drugs against HPV, it has no contraindications and can be used to treat young children. The recommended dosage is 1 tablet three times a day, duration of treatment is 10-14 days. Then you need to take a break for 10 days and repeat the treatment.
The maximum therapeutic effect can be achieved with local application antiviral and immunomodulatory drugs, as well as local funds, providing removal of papillomas.
Human papillomavirus infection is currently a common pathology. The causative agent of the disease mainly affects the mucous membranes of the throat, mouth, nose, and genitals. They are selected after undergoing an examination, during which the type of virus can be determined. Modern treatment methods can only get rid of external symptoms manifestations of the disease.
Causes of papillomas
Experts say that she is infected with the papilloma virus most of population, but the disease does not always manifest itself. Some people are not even aware of the infection and are only carriers. Appearance characteristic formations on the skin indicates the presence in the body of diseases of inflammatory etiology in an advanced stage. Papillomas can also occur due to severe stress.
Infection occurs not only through sexual contact (unprotected). Although this method is more common than others. You can become infected with the virus through contact with a carrier’s skin or through a kiss. The virus enters the body through wounds and scratches on the skin.
Symptoms
Papillomas look like moles with a short stalk. They look unaesthetic, especially on open areas of the body. Neoplasms appear most often in the genital area, both in women and in the stronger sex. Papillomas may have various shapes: flat, pointed, thread-like, mosaic-shaped. The color of the growth is slightly different from the skin and can be lighter or, conversely, darker. Depending on the external manifestation of the disease, the specialist selects the optimal medicine for papilloma.
A person infected with the virus is usually only concerned about the appearance of characteristic moles or warts. However, it has been established that internal organs are also under attack. During medical diagnostics, formations are identified on the mucous membrane of the stomach, bladder, and cervix.
How is papilloma treated?
Which medications are suitable for getting rid of those caused by HPV can only be determined by the attending physician (dermatologist, gynecologist or andrologist). It is highly undesirable to get rid of papillomas on your own. Modern medicine offers several ways to treat the pathological condition. Medication is the basis of therapy. The medicine for papillomas acts on the problem from the inside, blocking the proliferation of infection and improving the body's protective functions.
From the mucous epithelium and skin using methods such as cryodestruction, electrocoagulation, laser and surgical removal. One of modern methods Getting rid of an unpleasant cosmetic defect is the use of a radio knife, which cuts off not only the neoplasm itself, but also the epithelium.
Effective drugs for papillomavirus infection
It should be borne in mind that there are no medications that can destroy the papilloma virus in the body. A properly selected medicine for papillomas can improve the condition of the immune system and suppress the replication of the virus. It is not recommended to take such medications without a doctor's prescription.
To combat viral infections in dermatology and gynecology, the following medications are most often recommended:
- "Isoprinosine."
- "Cycloferon".
- "Interferon".
- "Panavir".
- "Viferon".
- "Feresol".
- "Verrukacid."
Some medications are quite complex and can cause side effects. After passing the examination, the doctor determines an individual dosage regimen.
Description of the drug "Isoprinosine"
Isoprinosine is considered one of the most effective drugs (according to many doctors) for eliminating papillomavirus infection. The drug belongs to the group of antiviral drugs and is capable of directly affecting the pathogen, preventing it from developing.
The drug for the correction of pathological conditions of the immune system is available in the form of tablets. The active ingredient is inosine pranobex (500 mg). The tablets have both antiviral and immunostimulating effects. “Isoprinosine” effectively suppresses the development of HPV (the production of the enzyme dihydropteroate synthetase is blocked), and by stimulating the body’s protective function, viral particles and infected cells are completely destroyed.
using Isoprinosine
The treatment regimen and dosage are calculated depending on the type of virus. For ordinary papillomas, drug treatment is quite sufficient. If condylomas are observed on the skin, in addition to tablets, surgical intervention is indicated.
Medicine for papillomas is taken for at least 14 days. The course of treatment can be extended up to 28 days on the recommendation of a specialist. The dosage depends on the patient's age. Children over 12 years of age and adults need to take two Isoprinosine tablets three times a day. In pediatric practice, tablets are prescribed to children from 3 years of age, calculating the dose of the active substance depending on the child’s weight. For 10 kg of body weight, 500 mg of inosine pranobex is indicated. That is, if a child weighs 15 kg, he needs to take 750 mg per day. The result obtained is divided into three doses (250 mg at a time).
When surgically removing papillomas and condylomas, it is also necessary to carry out antiviral therapy to prevent relapse of the disease. Before using the medicine, you must familiarize yourself with the contraindications.
Natural drug "Panavir"
Another medicine for papillomas is Panavir, which is based on substances of natural origin. The product has a wide spectrum of action and is used as a powerful immunomodulator and antiviral drug. Panavir is produced in the form of rectal and vaginal suppositories, gel and spray for external application, solution for injection.
Active substance"Panavira" is an extract from potato tops. It has been established that the substance has strong immunomodulatory properties and promotes the production of interferon in the body. For the treatment of papillomas, it is most often prescribed in the form of a gel, which is applied twice a day. In the form of rectal and vaginal suppositories, the product, according to experts, is also effective. Suppositories help get rid of papillomas in the anus and vagina.
Treatment of papillomas should begin at an early stage, without waiting for the moment when they begin to increase in size. According to patient reviews, the gel is well tolerated and does not cause allergic reactions. In most cases, it helps get rid of warts and various types of papillomas. If the growths are minor, it is sufficient to use only a product for external application. In more advanced cases, complex therapy is indicated.
In the form of a spray and gel, Panavir is used in pediatric practice. This is a medicine against papillomas natural basis can also be used to treat pregnant women.
"Ferezol" for papillomas
To fight with cosmetic defects on the skin caused by the presence of the papilloma virus in the body, you can use the drug “Ferezol”. The product is designed specifically for removing skin growths. The solution is effective for warts, papillomas and condylomas. However, it should also be used as directed by a specialist. The effectiveness of the drug is based on its cauterizing and mummifying effect.
How to use it correctly?
According to the instructions, the liquid medicine for papillomas is applied directly to the affected area and try to avoid getting the solution on healthy skin. You can first steam the area of the dermis with the neoplasm and allow the moisture to dry completely. This manipulation will allow the drug to penetrate into the deeper layers of the tumor. You can apply the medicine using a small stick.
If the papilloma is small in size, then a single use of the Feresol solution may be sufficient for removal. For large affected areas, it is necessary to apply the drug several times at intervals of 15-20 minutes. It is dangerous to use the product on some areas of the body, such as the armpits, due to the high risk of burns.
What do the doctor's say?
Experts strongly recommend that patients not self-medicate with condylomas and papillomas. Only a doctor can determine the appropriate therapy after the patient will undergo examination. The optimal medicine for papillomas and warts is selected individually for each patient. Some patients may only need medication to treat the disease, others cannot do without surgical removal growths. The duration of treatment also depends on individual characteristics body and the state of the immune system.
The papilloma virus most often affects only people who have regular sexual intercourse without using barrier methods of contraception. But there are also cases when the disease enters the body through the blood and while passing through birth canal. The disease itself is a small-sized neoplasm that can lead to cancer. It is especially important to treat papillomas in women, since in them they can penetrate the genital tract and lead to cancerous formations on the cervix and vaginal walls. Treatment most often has a combined, carefully thought-out nature.
Electrocoagulation
The procedure is carried out in a cosmetology salon. On average, removal of one papilloma costs a patient 100-120 rubles. The procedure is carried out using a small device through which current passes. He is sent to cauterize papillomas, which prevents their growth. The procedure is quite effective for removing existing papillomas and shows good results in 90% of cases. Moreover, after some time, 45% of patients developed new localizations of tumors. The procedure has a minimum of contraindications and side effects.
Laser therapy
It is also a fairly common hardware procedure that can allow women to get rid of existing papillomas by 92%. Success is influenced by the number of tumors, their nature and location. A rather painful procedure that leaves wounds on the body. Marks from laser therapy can take as long as a month to heal. After such treatment, relapses of viral damage were recorded in quite a few cases. Used to remove papillomas from the mucous walls of the vagina. The cost of such a procedure is 1000-2000 rubles.
Cryotherapy
The procedure is carried out using liquid nitrogen. Cryotherapy can remove approximately 60% of viral localizations. Moreover, after some time, in 15% of cases, patients experienced relapses of the disease, which required re-treatment. A rather expensive procedure that requires 10-20 sessions. The cost of cryotherapy ranges from 10 to 40 thousand rubles for the total number of manipulations.
Video - Removal of warts (papillomas) with laser, liquid nitrogen, current and radio waves
Radio wave
The procedure is carried out under local anesthesia. Radio wave removal involves removing the papilloma along with its root. To do this, a radio wave laser makes the most accurate size within 10-30 minutes, it all depends on the complexity of the procedure. Typically, patients need from 10 to 20 sessions to completely get rid of tumors. Relapse of the disease after such manipulations is 30%. The cost of radio wave surgery is from 3,000 to 10,000 thousand for the entire number of procedures.
Attention! The decision to carry out hardware treatment can only be made by the attending physician after an in-person examination of the tumors. This is important to do, because if the approach is incorrect, papilloma can grow much faster and enter the pathogenic stage.
Antiviral drugs against papillomas
Allokin-Alpha
The drug is available in powder form, which should be used to prepare a solution for injection. After preparing the solution, it is administered subcutaneously. When treating an oncogenic papillomas virus, six injections should be given. Each procedure is performed every other day. To prepare the injection, you should take a 0.9% sodium chloride solution, which allows you to create an ideal environment for the active substance.
Viferon
The medicinal product can be used to treat papillomas not only on the body, but also on the mucous membrane of the vagina and cervix. To get a good result, you should take one milligram of the active substance and apply it using a tampon or soft applicator to the affected areas twice a day. External manifestations are treated with local application of the product, also twice a day. The duration of therapy is determined by the attending physician and is usually 1-2 weeks.
If necessary, the gel can be replaced with rectal suppositories. They are more convenient and easier to use. Treatment requires the administration of only one suppository of medication after a natural bowel movement. This form of the drug affects all viral formations. The duration of therapy with suppositories is also 1-2 weeks.
Genferon
The drug is available in two pharmacological forms– vaginal and rectal suppositories. Rectal suppositories are used to treat papillomas localized on a woman’s torso. She is recommended to take one Genferon suppository for two weeks.
The vaginal and cervical mucosa should be treated with vaginal suppositories. Taking into account the severity of the disease, the patient may be recommended to put 1-2 suppositories. Treatment can continue for 10 days. Further increase in the course of therapy is permissible only with the permission of the gynecologist.
Attention! Taking antiviral drugs is also advisable during hardware treatment, which will consolidate the results obtained.
Immunomodulators for papilloma virus
Immunomax
This drug can only be used in combination with one of the above methods of hardware therapy. The Immunomax course consists of six procedures. Patients are administered the drug intramuscularly at a dose of 200 units of the active substance. Immunomax can be used only after receiving a detailed immunogram.
Lycopid
The drug is available in tablet form. If skin papillomas are affected, the patient is recommended to take 2 mg of the active substance sublingually twice a day. Therapy in this case continues for six days. When treating papillomas on the vagina and cervix, the patient should take 10 mg of Lycopid once a day for 10 days.
Attention! Typically, these drugs are prescribed only when combination treatment with antiviral drugs and hardware therapy has not given the desired result.
Cost of drugs against papillomavirus
| A drug | Image | Price in Russia in rubles | Price in Belarus in rubles | Price in Ukraine in hryvnia |
|---|---|---|---|---|
| Allokin-Alpha | 3500-7500 | 112-224 | 1435-2870 | |
| Viferon | 80-300 | 2,56-9,6 | 32-123 | |
| Genferon | 300-2000 | 9,6-32 | 123-820 |
Attention! The prices given may not coincide with prices in a particular pharmacy chain, as they are average prices. The cost is also affected by the dosage and location of drug production.
Traditional methods of treating papillomavirus in women
Celandine juice against neoplasms
The drug shows quite good results in the treatment of various types of papillomas. It is best to purchase a ready-made pharmaceutical solution that has the maximum safe concentration. Celandine should be used according to a strictly defined scheme:
- first you need to steam the problem area;
- after that it is lubricated with any fatty, non-allergenic base, it is best to use vegetable oil;
- after this, a small amount of juice is applied to the papilloma; it is important to avoid contact with healthy areas of the skin;
- the procedure is carried out 1-2 times a day;
- every 48 hours you should carefully remove dead areas of tumors;
- flat papillomas disappear on their own without external intervention.
The duration of treatment is determined by its success and continues until complete recovery.
Video - How to get rid of papillomas using folk remedies
Potato juice
Also excellent remedy, which does not have toxic and dangerous influence on the body and skin. Suitable for combination treatment not only with traditional drugs, but also with folk ones. Only freshly prepared juice can be used to lubricate papillomas. The procedure is repeated an unlimited number of times per day, since potato juice cannot cause allergies. This home remedy can also be used to lubricate new growths on intimate places and face.
IN last years In Russia, as in many countries of the world, the incidence of human papillomavirus infection is increasing. The problem of its diagnosis and treatment attracts the attention of doctors of various specialties: dermatologists, gynecologists, urologists, oncologists, pathomorphologists, immunologists, virologists. This is explained by the high contagiousness and tendency to increase the frequency of this disease, as well as the ability of some varieties of human papillomavirus (HPV) to initiate malignant processes. The latter mostly concerns the genital manifestations of human papillomavirus infection.
Human papillomavirus (HPV) is epitheliotropic and is found in the skin, oral mucosa, conjunctiva, esophagus, bronchi, and rectum.
There is information in the literature that the introduction of HPV infection occurs at the level of immature epithelial cells of the skin and mucous membranes (basal layer). The result of this invasion is cell proliferation, but without the production of viral particles, since proliferating epithelial cells are not able to maintain life cycle viruses. Complete replication of HPV occurs only in highly specialized cells of stratified squamous epithelium: granular, spinous cells of the skin, superficial epithelial cells of the cervical mucosa. Currently, about 100 types of papillomaviruses have been described. Their tissue and species specificity should be noted. Various types of HPV are associated with various types defeats. It has been established that certain types of HPV are associated with the urogenital area. There are varieties:
- low cancer risk;
- average cancer risk;
- high cancer risk.
Viral genome structure
Papilloma viruses belong to the papovavirus family ( Papovaviridae), affecting large cattle, birds, as well as humans and are capable of infecting basal cells of the skin and squamous epithelium. Papillomaviruses are one of the most heterogeneous groups of viruses, the differentiation criterion of which is the degree of genetic relatedness of the viruses according to molecular hybridization: it ranges from 10 to 85%. The diameter of viral particles is 55 nm. The virus does not have an outer shell. The virus capsid consists of 72 capsomeres. A detailed analysis of the HPV DNA molecule became possible after the development of a technique for DNA cleavage using endonucleases and analysis of these fragments using gel electrophoresis.
When studying preparations stained by Papanicolaou, a specific set of signs was identified that characterizes the nucleus and cytoplasm of epithelial cells (koilocytic cell atypia), caused by the cytopathic effect of papilloma viruses.
A specific cell for this infection is the koilocyte, which is an oxyphilt-stained epithelial cell with clear boundaries and a clearly defined perinuclear clearing zone and numerous vacuoles in the cytoplasm.
The term “koilocyte dysplasia” was introduced by H. S. Stegner in 1981. It is assumed that these changes are a consequence of the reproduction of a virus that causes disruption of cell metabolism, leading to their partial necrosis with the formation of balloon-like cells.
Cytological examination of lesions caused by HPV infection showed that the cellular material contains mostly anucleate, or orthokeratotic, cells. About 20% of scales contain nuclei - the so-called. "parakeratotic cells".
It should be remembered that morphology alone is not enough to identify HPV. In this regard, it is advisable to use the polymerase chain reaction (PCR) method, hybridization in situ. Increasingly, there are reports in the literature about the determination of HPV infection in urine using PCR as an alternative method for testing samples from the cervix. Along with this, nested PCR in one tube and type-specific nucleotide hybridization are used.
The PCR method is used for low-symptomatic or asymptomatic forms of the disease caused by HPV infection.
Immunochemical methods can detect HPV antigens in the tissues of genital warts in 71.4% of cases, by hybridization in 96.5% and by PCR in 10% of cases.
The effectiveness of DNA hybridization does not exceed the effectiveness of histological examination, but it allows identifying patients with a high degree of this infection.
HPV infection clinic
The clinical manifestations of genital HPV infection are highly variable. Currently, they are divided into genital condylomas, papillary varieties of condylomas (with pronounced exophytic growth), as well as flat and inverted (intraepithelial) with endophytic growth. The last option, also known as “subclinical HPV infection,” is the most difficult in diagnostic terms, since there are no clear microscopic changes in the epithelium. In this case, special screening techniques are required to determine clear boundaries of the lesion.
A peculiar variant of genital warts is bowenoid papulosis and giant Buschke-Levenshtein condyloma. Condylomas acuminata (AC) are fibroepithelial formations on the surface of the skin and mucous membranes, with a thin stalk or a wide base in the form of a single nodule or multiple epithelial outgrowths, resembling cockscombs or cauliflower in appearance. Diagnosis of large condylomas does not cause difficulties. Genital condylomas are localized mainly in places of maceration: labia minora, vagina, cervix, urethral orifice, anus, skin. In men, OK are located in the area foreskin, on the glans penis, perinatal area, less often endourethral. Incubation period ranges from one to 12 months (average 3-6 months).
Studies of recent decades indicate that 85% of patients with typical OC of the vulva and perineum have additional foci of HPV infection in the vagina or cervix, and almost every fourth of them has diseases associated with HPV infection - cervical intraepithelial neoplasia (CVN) of various types. degree of severity. One of the clinical types of diseases caused by HPV infection are bowenoid papules associated with HPV 16, sometimes pigmented on the skin and mucous membranes of both sexes, more often resembling common warts or seborrheic keratosis. In contrast to Bowen's disease, Bowenoid papules are benign and regress spontaneously, although they can occasionally become malignant. The course is asymptomatic.
Some authors include Lewandowski-Lutz epidermodysplasia verruciformis in this group of diseases. This disease is based on local and genetic disorders associated with chronic HPV infection.
J. M. Handley and W. J. Dinsmore (1994), based on literature data, as well as their own research, proposed a classification of clinical forms of HPV infection and associated diseases ().
In the vast majority of cases, manifest forms of HPV infection are combined with other sexually transmitted diseases. According to Bernard K. and Mugi K. (1996), manifest forms of HPV infection usually arise as a result of a number of factors:
- social;
- infectious, associated with associations of sexually transmitted diseases (STDs);
- associated with changes in immune status.
The most significant is the influence of urogenital tract infections associated with HPV lesions: urogenital chlamydia, mycoplasmosis, cytomegalovirus and herpetic infection, dysbiotic conditions. The result of their influence on the course of HPV infection is the chronicization of the process, the formation of persistent, usually nonspecific inflammatory changes in the genitourinary area and significant difficulties in carrying out therapeutic measures.
The significance of the presence of concomitant infection for the treatment of condylomatosis is explained by the following circumstances.
- The presence of STDs associated with HPV infection prolongs the treatment period for the latter by an average of three times.
- In most cases, relapses are associated with the above reason.
- Epithelization of cervical erosions after destruction of condylomas can be achieved only if there is a preliminary scan for concomitant STDs and bacterial vaginosis.
The possibility of a relationship between cervical neoplasia and sexually transmitted diseases has been discussed for many years. In a group of women suffering invasive cancer cervix (CC), a higher frequency of detection of nonspecific microflora, including Trichomonas and Gardnerella infections, was noted. Examples of such influence have been discussed in relation to Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis, herpes simplex virus type 2, cytomegalovirus, human papillomavirus. Epidemiological studies have convincingly shown that genital HPV infection is an undeniable risk factor for the occurrence of precancerous changes and cervical cancer.
Principles of treatment of HPV infection
Considering the fact that specific antiviral drugs and vaccines that act on HPV are not yet available, it is generally accepted that complete elimination of the virus from the body cannot be achieved. The goal of therapy is to eliminate clinical and subclinical forms of HPV infection.
Today, practitioners have many methods for removing anogenital warts in their arsenal. Their effectiveness varies from 30 to 90%, but none of the methods is a panacea, since the relapse rate is quite high with any method of treatment. Treatment must be strictly individual: it is necessary to select the most optimal solution in each specific case, sometimes taking into account the wishes of the patient himself. The problem of relapse does not depend on the choice of therapy. Recurrences of anogenital warts are most often associated not with reinfection from a sexual partner, but with reactivation of the infection. There are three ways that events can develop in the absence of treatment:
- warts may resolve on their own;
- remain unchanged;
- progress.
At the same time, one must always take into account the possibility of persistence of the virus in the absence of any clinical manifestations.
When choosing the most optimal method in each specific case, you must be guided by four main characteristics:
- effectiveness for this pathology;
- relapse rate after treatment;
- tolerability (minimal side effects);
- ease of performing procedures.
In addition to removing anogenital warts, it is necessary to solve the following important problems:
1. Identify and treat other sexually transmitted diseases (STDs) in patients with anogenital warts (and their sexual partners).
2. Screen all women with anogenital warts for cervical intraepithelial neoplasia (CVN) using cytology and colposcopy.
3. Maintain further monitoring of CVN lesions in the early stages for timely detection of their progression or development of microinvasive carcinoma.
4. Carry out active treatment of anogenital warts, neoplasia in the early stages, occurring with advanced clinical picture, advanced neoplasia and squamous cell carcinoma.
In fact, treatment of anogenital HPV lesions is aimed either at destroying papillomatous lesions by one method or another, or at stimulating an antiviral immune response; a combination of these approaches is possible.
Destructive methods
Physical destructive methods
Surgical excision. Currently used infrequently, mainly used in the treatment malignant neoplasms when wide excision is necessary. This method may require hospitalization due to the fact that during excision there may be quite a heavy bleeding, and a long postoperative period will require special therapy.
Electrosurgical methods. These include electrocoagulation, electroacoustics, fulgation, electro surgical excision(electroexcision) using an electric knife. Not so long ago, plasma began to be used in medicine. Our scientists have developed an original plasma coagulator (plasmaskin) EKH-1, which does not have foreign analogues. Temperature measurements in plasma showed that it can reach 2000-2500°C. Such high temperature values, in turn, provide the ability to work in a non-contact mode, significantly reducing the operation time and thereby reducing the necrosis zone. In addition, with this effect in most cases the pain threshold is not exceeded. The temperature regime ensures almost complete combustion of tumors.
Advantages of this method:
- availability;
- cheapness;
- fairly high efficiency;
- possibility of use in outpatient settings;
- the risk of bleeding is reduced.
Flaws:
- need for pain relief
- When using this method, infectious HPV DNA is released along with the resulting smoke, so it is necessary to create adequate working conditions - vacuum extraction of smoke, the use of protective masks.
Laser excision. Quite effective and safe method is the excision of warts using a laser. Neodymium and CO lasers are used in practice. When using a CO laser, surrounding tissues are less damaged, and a neodymium laser provides a better hemostatic effect. In addition to the laser physically removing lesions, studies have shown that laser radiation has an effect on HPV toxic effect. The procedures require well-trained personnel. When using lasers, anesthesia is necessary - often local or local anesthesia is sufficient, which allows the procedures to be performed on an outpatient basis. Laser excision and surgical methods are approximately equally effective. Laser therapy can be successfully used to treat common condylomas that are resistant to other treatments. It allows you to stop recurrence in approximately 40% of patients. Research has shown that this lack of effectiveness is due to the fact that the CO laser is ineffective when it comes to eliminating genomes from lesions that are resistant to treatment (according to PCR method, molecular biological cure occurs in 26% of patients).
The use of a CO laser is the method of choice in the treatment of CVI. Laser conization of the cervix is used. Relapses occur in 2% of patients. A mild method of laser therapy is vaporization, which does not cause virtually any complications. Laser vaporization has been successfully used in the treatment of low-grade CVN. Relapses are observed in 4% of patients.
Laser therapy has been successfully used to treat genital warts in pregnant women. There are reports of treatment in pregnant women at 28-35 weeks of pregnancy. For most patients, healing occurred after the first session. There were no complications during childbirth or in newborns.
Side effects include ulceration, bleeding, secondary infection, and scarring. As with electrosurgical methods, HPV DNA is released through smoke, which also requires precautions.
Laser therapy is not widely used due to the high cost of equipment and the need to train experienced personnel.
Cryotherapy. A fairly effective and safe method that involves the use of liquid nitrogen, nitrogen oxide and carbon dioxide as a refrigerant. In this case, rapid freezing of both intra- and extracellular fluid occurs, leading to lysis and death of cells upon thawing. Cryotherapy does not usually require pain relief, although it can be used if necessary. local anesthetics. Cryotherapy can be used to treat small warts various localizations. If the warts are multiple, then removal should be carried out in several stages. This method is characterized by the following side effects: the development of local redness, swelling, followed by the formation of blisters and their ulceration. To reduce damage to surrounding tissues, before the procedure, the surface of the warts is treated with KY-gel, which, when frozen, makes it possible to carefully lift and separate the lesion from the underlying epithelium.
The method can be used in gynecological practice.
We think the combined use of cryodestruction and plasma coagulation is extremely promising, allowing us to avoid the disadvantages inherent in the above methods separately.
Chemical destructive methods. This group of products includes solutions of acids, alkalis, and salts. Among them we can mention Feresol, hydrogen peroxide, solutions of quinacrine and hingamine, preparations of mercury and arsenic, bismuth, preparations based on salicylic and lactic acids, acetic and nitric acids, thuja and celandine juices. All these drugs are easily available, but have low, poorly predictable effectiveness, and produce numerous side effects.
Isoprinosine should be used in combination with locally destructive methods of treatment.
The effectiveness of combination treatment for PV, according to the literature, ranges from 38 to 96%.
Combined treatment methods. To treat the manifestations of HPV infection, various methods are proposed, based on the use of immune drugs in combination with laser, electrosurgical and cryodestructive effects.
The combined use of the above methods can reduce the number of relapses and thereby increase the effectiveness of treatment.
Good results were obtained using a combined method of treating condylomas, including destruction of lesions using cryodestruction (exposure temperature from -160 to -180°C, exposure 40-120 s, twice) in combination with immune stimulation. To stimulate local immunity, the affected area was treated with an emulsion containing interferon (IF), and to stimulate the immune system of the whole body, the drug Kemantan was prescribed at a dose of 0.2 g three times a day orally for 10 days.
A combination of various destructive methods is possible. If there are manifestations of HPV infection on the skin and mucous membranes, cryospraying is first performed for 10-30 s, which makes it possible to clearly identify the boundaries of the lesion due to the characteristic papillary surface of the lesions, which turns white. Then the affected area is exposed to plasma (using the plasmaskin device).
A number of researchers the best way Treatment of anogenital warts involves surgical removal of all visible lesions followed by local administration of IF. In some cases, it is advisable to use general and local IF before surgical excision of extensive condylomas.
There is no therapeutic effect from the use of IF if the disease lasts more than one year, as well as with immunodeficiency.
Currently, there are not many remedies that can be used after using destructive methods. In particular, the drug impran has now appeared for local use in the area of lesions after destructive effects.
Specific antiviral therapy
Currently, there are no drugs that have a specific effect on HPV. Known drugs that suppress the replication of the herpes simplex virus (acyclovir, ganciclovir) turned out to be ineffective in the treatment of anogenital HPV infection.
Theoretically, vaccination is an ideal method for the treatment and prevention of anogenital warts.
There are reports of effective application inductors IF. Of interest is the local use of a low molecular weight derivative of imiquidaquinolamine, imiquimod, which is an inducer of cytokines and, in particular, L-IF. It is used in the form of a 5% cream three times a week or daily at night until the rash completely disappears (but not more than 4 months). Complete disappearance of condylomas is observed in 13-56% of cases. With daily use, local side effects more often developed: redness, swelling, erosion. The cream is especially indicated for the treatment of subclinical HPV infection. It is possible to use virazole.
The effect of using IF monotherapy has not been sufficiently studied and is not very high; in addition, it is necessary to take into account the high cost of such treatment. In this regard, this method is not widely used in practice.
Isoprinosine. In recent years, the new immunomodulator isoprinosine, which is a complex of inosine and the salt of N,N-dimethylamine-2-propanol and P-acetaminobenzoic acid, has attracted the close attention of immunologists. The drug can be used in the form of tablets or a solution for parenteral injection. The active substance in this complex appears to be inosine, and the amino alcohol salt stimulates its penetration through the membrane of lymphocytes and other cells.
Isoprinosine has a powerful and broad immunomodulatory effect. Numerous data and extensive literature indicate that in vitro the drug significantly enhances the proliferation of T lymphocytes induced by mitogens or specific antigens, as well as the differentiation of pre-T lymphocytes into more mature T lymphocytes, accompanied by the appearance of corresponding antigens on their surface. PI also stimulates mitogen-induced B cell proliferation. The stimulating effect of isoprinoline on the activity of natural killer cells (NK cells) in healthy people and the functional ability of cytotoxic T lymphocytes has been proven. The drug improves the CD4+/CD8+ ratio; increases the production of IL-2 by T lymphocytes; promotes the maturation and proliferation of T cells; activates the synthesis of IL-1 by macrophages. PI has an antiviral effect and prevents the use of ribosomal RNA for virus replication. It should be noted that when isoprinoline was used with other immunocorrectors, it significantly enhanced the antiviral effect of the latter.
Various treatment regimens using isoprinoline have been adopted depending on the size of condylomas, their location and the degree of malignancy.
Scheme 1: treatment of small, multiple genital warts with a low degree of malignancy.
The drug is taken in 2 tablets. three times a day for 14-28 days.
Scheme 2: treatment of multiple condylomas with individual large condylomas or flat condyloma of the cervix.
Among the chemicals used in our country and abroad that have a destructive effect are TCA and nitric acid, as well as a combined acid preparation - solcoderm.
TCA and nitric acid. TCA is used in 80-90% concentration and causes the formation of local coagulative necrosis. Similar action provides a solution of nitric acid. Due to their cheapness and availability, both methods are quite widespread to this day. Acids are effective for the treatment of condylomas of the vulva, preputial sac, coronary sulcus, glans penis, especially in cases where the use of PF and PFG is contraindicated. Cauterization is carried out once a week for 5-6 weeks. The effectiveness of using TCA and nitric acid is approximately 70-80%. In some cases, a local reaction may develop in the form of weeping and ulceration.
Solcoderm. Solcoderm - water solution, the active component of which is the interaction products of organic acids (acetic, oxalic and lactic) and metal ions with nitric acid
Acid. The solution contains nitrites in an amount of 0.02 mg/ml.
Listed below are the properties and mechanism of action of Solcoderm, which distinguish it from other drugs in this group used as part of destructive methods:
- when applied topically, solcoderm causes immediate intravital fixation of the tissue to which it is applied;
- the effect of the drug is strictly limited to the place of application;
- a sign of an immediate effect is a change in the color of the treated area;
- devitalized tissue dries out and darkens (mummification effect);
- The “mummified” scab is rejected on its own;
- The healing process is short and complications (secondary infection or scarring) are rare.
General characteristics of treatment with Solcoderm:
- the drug has a precisely limited local effect on the pathologically altered tissue to which it is applied, while the surrounding tissue is not damaged;
- the method is suitable for the treatment of various skin tumors;
- the treatment is painless;
- fast healing, no complications;
- treatment is carried out on an outpatient basis and does not require special equipment;
- absence of any restrictions for the patient.
Indications for the use of Solcoderm: simple warts, plantar warts, anogenital warts (genital warts), seborrheic keratoses, actinokeratoses, basal cell epitheliomas (basaliomas).
Solcoderm is very easy to use and quite effective for the treatment of condylomas of any location. In most cases, a single application is sufficient.
Cytotoxic drugs
Podophyllin (PF). Pofillin is a resin obtained from plants. P.pelatum and P.emodi, growing in North America and the Himalayas. To treat warts of the anogenital area, a 10-25% solution of PF in ethanol or benzoin tincture is used. It binds to the microtubule apparatus of the cell and inhibits mitosis, and also inhibits the transport of nucleic acids, resulting in inhibition of DNA synthesis and cell division.
The use of PF is a simple, affordable, fairly safe treatment method that can be used in an outpatient setting, as well as by patients independently. The drug is applied once or twice a week for a maximum of 5 weeks in an amount of no more than 0.5 ml per procedure. The patient must ensure that water does not enter the treated area for 4-6 hours after the procedure. PF is not recommended for use on vaginal, cervical and intraepithelial warts. According to some authors, the recurrence rate varies from 0 to 67%.
Approximately 10-15% of patients develop local adverse reactions in the form of weeping contact dermatitis. Particularly severe complications in the form of multiple ulcerations occur when used incorrectly. As a result of long-term or improper use of PF, patients may experience various adverse reactions, such as nausea, vomiting, abdominal pain, diarrhea, symptoms of kidney, myocardial, liver, central nervous system and bone marrow damage.
The use of PF is contraindicated during pregnancy, since cases of teratogenic effects on the fetus and intrauterine fetal death have been reported.
Many researchers consider PF to be an insufficiently studied and crudely purified plant extract, and therefore recommend using only highly purified podophyllotoxins, and independent use of the drug by patients themselves is undesirable due to the above-mentioned complications.
Podophyllotoxin (PFT) (condylin). PFT is the most therapeutically active fraction of PF. Available in the form of solutions of 0.25, 0.3 and 0.5%, as well as in the form of cream 0.15, 0.3 and 0.5%.
It is usually prescribed twice a day for three days a week in a row for 4-5 weeks.
Although PFT is better purified than PF, a high incidence of side effects has been reported with the use of PFT, especially its 0.5% solution. The following side effects are most often observed as a result of the use of PFT: local inflammatory reactions (erythema, burning, soreness, itching, weeping and erosion in the area of application). Although systemic side effects have not been reported in the literature, it is recommended to limit the use of PFT to a dose of 0.2 ml per treatment.
The disadvantages of PFT are its high cost and long duration of treatment.
5-fluorouracil (5-FU). 5-fluorouracil (5-FU) is a pyrimidine antagonist and has the ability to disrupt the synthesis of both cellular and viral DNA. For the treatment of warts of the anogenital area, it is prescribed in the form of a 5% cream. When treating intravaginal warts, the drug is prescribed once at night for a week or once a week for 10 weeks. The degree of effectiveness of the drug, according to various researchers, is 85-90%. When using 5-FU, weeping erosions on the vaginal mucosa may occur, up to the development of severe weeping contact dermatitis. When treating warts of the terminal part of the urethra, the cream is administered immediately after urination at night for 3-8 days. Complete cure intraurethral warts are observed in 90-95% of men. However, during treatment there are many side effects: stenosis and stricture of the urethra, dysuria, ulceration. The drug is contraindicated during pregnancy.
Immunological methods
Interferon. Since the human papillomavirus persists in epithelial cells and the use of destructive methods does not guarantee against relapses, the use of IF is promising in this regard, both as monotherapy and in combination with other treatment methods.
IFs are endogenous cytokines with antiviral, antiproliferative and immunomodulatory properties. There are three main classes of IF: leukocyte (L-IF), fibroblast (F-IF) and T-lymphocyte (T-IF). IF can be used locally, intralesional and systemically (subcutaneous, IM or IV). It has been established that when using IF in patients, the amount of viral DNA in the lesions decreases (according to PCR data), which correlates with clinical improvement or disappearance of the lesion.
There is data regarding the use of domestic IF, human leukocyte interferon (HLI), for the treatment of condylomas. It was used intralesional (under papilloma) at a dose of 100,000-500,000 IU, for a course of 3-6 procedures in combination with the application of interferon ointment with an activity of 40 IU to the lesions. PLI can be prescribed systemically and in the treatment of widespread lesions in combination with destructive methods.
Most effective drug at in various ways, schemes and doses of administration can be considered L-IF. With systemic use of L-IF, complete disappearance of warts was observed in 11-100% of patients. The effectiveness of using F-IF was 45-82%. The effectiveness of T-IF, shown in different studies, is much lower than that of L-IF and F-IF, and varies from 7 to 57%.
It should be remembered that the unsystematic use of various treatment methods leads to a high percentage of relapses, however, the development of certain algorithms that take into account the gender of patients, the location and number of rashes can significantly reduce the number of relapses.
Table 1. Anogenital HPV infection and HPV-associated diseases
HPV infection
Detailed clinical forms (visible to the naked eye or invisible, but determined in the presence of appropriate symptoms):
- warts (genital condylomas, flat condylomas, vulgar warts)
- symptomatic intraepithelial neoplasia in the early stages - koilocytosis, dyskeratosis in the absence of dysplasia (flat condylomas)
Subclinical forms (not visible to the naked eye and asymptomatic, detected only by colposcopy and/or cytological or histological examination
- asymptomatic intraepithelial neoplasia (IN) in the early stages - koilocytosis, dyskeratosis in the absence of dysplasia (flat warts)
Latent forms (no morphological or histological changes when HPV DNA is detected)
Table 2. Diseases associated with HPV
Clinical and subclinical forms:
- VN in the early stages - mild dysplasia, /+-/ koilocytosis, dyskeratosis (VN stage 1)
- VN in late stages - severe dysplasia, /+-/ koilocytosis, dyskeratosis (VN stage 2)
- Late stage LN - severe dysplasia or carcinoma in situ /+-/ koilocytosis, dyskeratosis (stage 3 LN, or CIS)
Microinvasive squamous cell carcinoma:
- clinically visible or invisible, but in the presence of appropriate symptoms
- subclinical, not visible to the naked eye and asymptomatic, revealed only by cytological and histological examination
- latent - absence of morphological and histological changes when detecting DNA HPV infection by molecular hybridization
- intraepithelial neoplasia
Table 3. Classification of treatment methods for anogenital warts
Destructive methods
- physical
- surgical excision
- electrosurgical methods
- cryotherapy
- laser therapy
- chemical
- Nitric acid
- trichloroacetic acid (TCA)
- solcoderm
Cytotoxic methods
- podophyllin (PF)
- podophyllotoxin (PFT)
- 5-fluorouracil
Immunological methods
- interferons
- isoprinosine
Combined methods
- combined use of various methods
